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Floating abscess in the inferior vena cava
  1. Shogo Shirota1,2,
  2. Satoshi Yoshikawa2
  1. 1 General Internal Medicine, Kobe City Medical Center General Hospital, Kobe, Japan
  2. 2 Emergency and General Internal Medicine, Rakuwakai Marutamachi Hospital, Kyoto, Japan
  1. Correspondence to Dr Shogo Shirota, General Internal Medicine, Kobe City Medical Center General Hospital, Kobe 650-0047, Japan; fanshawe365{at}gmail.com

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A 92-year-old woman presented to the emergency department with fever. She had no relevant medical history. On physical examination, the abdomen was soft and non-tender. Contrast-enhanced abdominal CT scan revealed a caudate lobe liver abscess with rupture into the retroperitoneal cavity (figure 1). Blood culture was positive for Klebsiella pneumoniae. Fever persisted even after the administration of intravenous antibiotics and percutaneous drainage, and CT re-examination showed no remote abscess but a new filling defect in the inferior vena cava (IVC) (figure 2A), suggesting a thrombus. However, X-ray fluoroscopy revealed a floating mass filled with contrast material, indicating an abscess extending …

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Footnotes

  • Contributors All authors treated the patient and prepared the manuscript, primarily written by SS. Performed the percutaneous drainage and supervised the workup: SY.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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